Toothache under a crown

definition

When the dentist speaks of "toothache under a crown", he means pain under a previously artificially fabricated tooth crown, e.g. under a gold crown.

The toothache usually occurs suddenly and violently and is usually accompanied by a throbbing and severe pressure sensitivity.

It does not matter whether the artificial tooth crown was made recently or was used years ago. These symptoms can occur at any time.

causes

Pain under a crown is caused by a variety of causes. The most important and most common is the Root inflammation. It can be removed from the tooth bed in the case of a crown (Periodontium) go out or by those left behind Bacteria in the root canal after a Root canal treatment to be triggered.
A flare-up of the apex inflammation typically occurs when the body has a reduced defensive position, such as a cold. The inflammation can progress quickly and cause pus to develop. A painful one abscess, which can spread over the entire head and jaw area, is the result.

You might also be interested in: Inflammation under a crown & Toothache - what are the possible causes?

In addition is also Caries responsible for pain under a crown. She will be here Secondary caries called and often forms on Crown marginif the artificial crown does not fit exactly gap is present or if the original Caries not removed properly has been. This is diagnosed by scanning the crown margins with special instruments (hooked probe). An x-ray often does not show the desired information because the caries is covered by the metal or ceramic of the artificial tooth crown.

With a newly made crown there is the possibility of one Dissection trauma. The tooth nerve was so strongly irritated by grinding ("drilling") that it became inflamed, causing pain under the crown.

diagnosis

A diagnosis of toothache under a crown can be made only from a dentist respectively.
After this Patient talk follows the Examination of the sore tooth. First are the teeth with Mirror and probe inspected. Especially the transition areas between the natural tooth and the artificial crown are carefully scanned with the hook probe. Soft tooth structure and crevices indicate secondary caries.

After that, the dentist does one Sensitivity test with a cold cotton pellet by. If the patient feels the cold, it can be assumed that the tooth is still alive. If this test is negative, i.e. the cold stimulus is not registered by the patient, this may be due to the thickness of the crown material and is not necessarily an indication of a dead tooth nerve.

This is followed by a Percussion test. To find out if the affected tooth hurts more than those around you, be careful with one Instrument tapped. An increased pain perception compared to the rest of the teeth is an indication of a root tip inflammation.

Before the dentist begins any treatment, one more will be done X-ray image made to confirm the diagnosis. If there is a black area around the painful tooth in the picture, it is a bone damage that also indicates a root inflammation.

Additional symptoms

Typically, both severe and mild toothaches are triggered under a crown in response to certain stimuli. Especially cold, warmth and pressure are the polluters, the special during the meal Cause pain. But they can also exist spontaneously or in phases.

In addition, there are a few symptoms that may appear, but not always. In this context will often Tartar and Bleeding gums observed. Tartar is mineralized deposits on the tooth near the gums. As this is irritated, bleeding gums can occur.

Most often there are also deep gum pockets and exposed tooth necks.
The tooth preparation (grinding or drilling) for a crown sometimes causes the gums to retract and leave behind exposed tooth necks. The teeth become very sensitive and react to the smallest changes in the oral cavity.

Find out more about Pain in the neck of the tooth.

In the context of acute inflammation, the usual ones also occur Signs of inflammation (pain, redness, pressure, warming, impaired function). Inflammation around the teeth can also affect the whole body; typical here are fever, swelling and fatigue.

therapy

Secondary caries under the crown margin

Treatment for this symptom is not always the same as it depends on the cause. Only after the diagnosis has been made does the dentist initiate the correct treatment measure.

Will the pain be through a Secondary caries triggered, the old artificial Dental crown removed and the Caries removed become. Then the tooth is assessed and a decision is made as to whether it can be preserved or not. Sometimes a restorative filling is necessary for crown preparation or root treatment before a new crown is made. In other cases, the tooth needs to be extracted and a dental bridge or prosthesis made.

At a Root canal inflammation must get one asap Root canal treatment be initiated so that it does not spread the inflammation to surrounding tissue and, in the worst case, lead to the loss of the tooth.

A Self-treatment using medication or home remedies is allowed for a maximum of two days respectively. But caution should be exercised in doing this, as taking pain relievers only relieves the symptoms, not the cause. Therefore, a visit to the dentist is strongly recommended.
If the symptoms do not go away during this time, a dentist must definitely be seen. Otherwise the inflammation could spread further and cause serious damage.

Treatment with home remedies

Home remedies should only be used under a crown for toothache Used for a maximum of one to two days become. The natural ingredients that are commonly used for toothache are chamomile tea, clove oil or cloves.

As Flushing works strong chamomile tea anti-inflammatory.
Clove oil is dripped directly onto the affected area and causes a short-term elimination of pain. If there is no oil on hand, one can whole clove chewed up become. This has the same effect.

Some patients also swear by it alcohol. This is going for some relief not drunkbut used as a rinse.

warmth can a Aggravate inflammation, you should definitely avoid them. Bacteria can spread faster in the heat and promote the disease.

In contrast, narrows cold the blood vessels and can thus reduce pain for a certain period of time, especially in severe cases Swelling.

Also a treatment with Painkillers like ibuprophen or paracetamol have proven themselves in the mouth and jaw area. It is essential to pay attention to the information on the package insert or the instructions from your family doctor, dentist and pharmacist regarding the dosage and duration of use.

Duration

The duration of the pain is extremely variable and very different from patient to patient. Sometimes there is only a short episode of pain and after a short time you are symptom-free again. This typically happens as an accompanying symptom of a small cold or the like.

However, if tooth decay or an inflammation of the apex are responsible for the pain, then the symptoms can last for a long time and get worse. Initially, depending on the stimulus, they can occur through hot and / or cold food and drinks or through pressure, later the transition to a permanent state is possible.
However, persistent severe or throbbing pain is not to be trifled with; a visit to the dentist should be carried out quickly. In this case, pus formation is very likely and, if left untreated, an abscess and bone loss will result.

Pain under a crown on the root-treated tooth

A crowned tooth, of the root canal treated pain may start again after a few months or years. Here is the inflammationthat the root canal treatment attempted to eliminate, erupted again. Insufficient preparation or rinsing leaves contaminated (non-sterile) tissue in the tooth, in which bacteria can still reside. These multiply when the body's defenses are poor and cause pain.

The situation is similar if a Root canal instrument in treatment canceled is. In this case it is Not always possible, the fragment remove completely. Bacteria remain in the canal and trigger inflammation.

A Root tip inflammation but can also over the tooth bed (periodontium)without the root canal being affected by bacteria. Then it may be that the inflammation does not go away even after renewed root treatment. If you want to keep the tooth anyway, you should have a Apical resection be tried. The inflamed part of the root is surgically removed and the root canal is closed from the lower side.

Pain of a crowned tooth when biting

If pain occurs under a tooth crown when clenching or chewing, this is called Bite sensitivity. See also: Pain when chewing

The Root tip inflammation is typically associated with bite pain. They are characterized by a throbbing or strong pulling that is relieved by the cold.

Also one wrong tooth position, so if the upper and lower teeth do not mesh properly, the cause of the hypersensitivity can be. Very often the reason is one newly installedbut not well adapted Crown or prosthesis or one new filling (Restoration).
In the first few days it usually feels as if the artificial tooth crown is too high, as it meets its opponent before all other teeth. This chronic overload of the crowned or filled tooth causes the pain.
A Grinding back the restoration or crown the dentist then provides relief because the height of the tooth is now back to normal.

Furthermore, the wrong bite can trigger a disproportion in the musculoskeletal system. He favors Pain throughout Masticatory muscles and in the temporomandibular jointwhich also cause severe headaches in some patients. An improvement in these muscular complaints only occurs when the cause is eliminated.

More on the subject: Temporomandibular joint pain